Blue Review - October 2021 | view in Web Browser
A Provider Publication |
October 2021
What's New
Blue Review Readership Survey: Your Voice Matters
The 2021 Blue Review readership survey will be open through the end of November. Your input will inform our plans to enhance the Blue Review and other provider communications in 2022. We look forward to hearing from you.
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2022 Telehealth Services
In support of our members and employer groups, in 2022 Blue Cross and Blue Shield of Illinois (BCBSIL) will continue to cover the expanded telehealth services that we’ve covered in 2021. Read more on News and Updates.
Community Involvement
Blue Door Neighborhood CenterSM Celebrates National Hispanic Heritage Month and Highlights Breast Cancer Awareness Month
Your patients are invited to join us at the Blue Door Neighborhood Center (BDNCSM) to celebrate National Hispanic Heritage Month on multiple dates, times and locations.
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Wellness and Member Education
Supporting Quality Care During Breast Cancer Awareness Month
October is Breast Cancer Awareness Month and a great time to talk with our members about the importance of regular screenings. Screening is the best way to find breast cancer early, when it’s easier to treat, and may help reduce the risk of death.
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Reminder: Controlling High Blood Pressure
A healthy blood pressure can help prevent heart disease, stroke and kidney disease. Controlling high blood pressure is recognized as a quality measure from the National Committee for Quality Assurance (NCQA). It assesses adults with a diagnosis of hypertension whose blood pressure is controlled. We encourage you to document our members’ systolic and diastolic blood pressure readings in their medical records at every appointment. For other quick recommendations, reminders and resources, see our April 2021 article, Blood Pressure Control: Speaking Out About the ‘Silent Killer.
Relaxed COVID-19 Mitigation Measures May Equal More Flu
Getting the flu vaccine is the first and most important step in protecting against influenza and its potentially serious complications.
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Pharmacy Program
Coverage Replacement for Smoking Cessation Product CHANTIX® Due to Voluntary Recall
Drug manufacturer Pfizer has issued a voluntary recall of its CHANTIX smoking cessation product. To help alleviate a shortage of these products, BCBSIL is temporarily covering Apo-Varenicline (varenicline tartrate) 0.5 mg and 1 mg tablets.
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Electronic Options
Check Eligibility and Benefits: Don’t skip this important first step!
Is your patient’s membership with BCBSIL still active? Are you or your practice/medical group in- or out-of-network for a specific patient? Is prior authorization required for a particular member/service?
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Update: View Professional Provider Fee Schedules via Availity®
In the November 2020 News and Updates, we confirmed the launch of the Fee Schedule Listing tool via the Availity Provider Portal. Recently, we updated this online tool to include a Network dropdown menu on the Tell Us About Your Organization page.
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Claims and Coding
Fighting Fraud, Waste and Abuse: Billing a COVID-19 Vaccine Administration
BCBSIL has become aware of several cases involving Evaluation and Management (E/M) visits being billed on the same claim as COVID-19 immunization administration services. BCBSIL’s guidelines state, “When billing a vaccine administration code with an office visit, if the vaccine is not the primary purpose of the office visit, bill the vaccine on a separate claim.”
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Reminder: CPT® Codes May Change
As a reminder, Current Procedural Terminology (CPT) codes may change throughout the year due to changes (new, replaced or removed codes) implemented by the American Medical Association (AMA).
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Change to Some Primary and Secondary Claims Coordination, Effective Dec. 13, 2021
As of Dec. 13, 2021, we’ll be making changes to increase efficiencies in coordinating claims for providers when a BCBSIL member has primary and secondary health insurance coverage from two BCBSIL health plans or BCBSIL and one of four other plans.
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New Laboratory Policies Coming Jan. 1, 2022
Beginning Jan. 1, 2022, BCBSIL will implement new policies and a new program for claims for certain outpatient laboratory services provided to our fully insured commercial, non-HMO members. Our New Laboratory Management Program will help ensure our members get the right care at the right time and in the right setting.
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Clinical Updates, Resources and Reminders
Reminder: Prior Authorization Vendor Change for Pharmacy Medical Oncology – Join Us for A Webinar
Starting Oct. 11, 2021, AIM Specialty Health® (AIM), rather than BCBSIL, will manage prior authorization requests and post-service medical necessity reviews for drugs in the Pharmacy Medical Oncology care category for some of our commercial, non-HMO members. Sign up now for a webinar to learn more.
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Are you using these shared decision-making aids?
Shared decision-making is a communications process. It’s a way for providers and patients to make informed health care decisions that align with what matters most to patients.
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Focus on Behavioral Health
Earn CME/CEU Credit at Free Webinar on Comorbid Conditions
Join our board-certified psychiatrists and behavioral health medical directors for a one-hour webinar on comorbid behavioral health and physical health conditions. The free webinar is on Monday, Oct. 25, 2021, at 8 a.m., CT.
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Quality Improvement and Reporting
2021 Annual HMO and PPO HEDIS® Reports
Each year, BCBSIL reports audited Healthcare Effectiveness Data and Information Set (HEDIS) results.
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Provider Education
Network Operations Update: Voicemail and Email Deactivation, Answers to Commonly Asked Questions
In an effort to streamline provider inquiries and improve administrative processes, the BCBSIL Network Operations team is retiring the following phone number/voicemail and email address: 312-653-6555, NetOps_provider_update@bcbsil.com.
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Provider Learning Opportunities
BCBSIL offers free webinars and workshops for the independently contracted providers who work with us. A preview of upcoming training sessions is included in this month’s issue.
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Notification and Disclosure
Important Dates and Reminders
Check here each month for a quick snapshot of recent implementations, upcoming changes, special events, important deadlines and other reminders.
Procedure Code and Fee Schedule Updates
As part of our commitment to help inform our independently contracted providers of certain developments, BCBSIL has designated a specific section in the Blue Review to notify you of any significant changes to the physician fee schedules.
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Stay informed! Watch the News and Updates on our Provider website for important announcements. Update Your Information Do you need to update your location, phone number, email or other important details on file with BCBSIL? Use our online forms to request an information change. Provider Training For dates, times and online registration, visit the Webinars and Workshops page. |
Quick Reminders
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